| Objective: To investigate the dynamics of change in patients with ocular ischemic vascular(blood flow forward and reverse ophthalmic artery blood flow) carotid stenting ball syndrome, provide reference data for clinical diagnosis and treatment of ocular ischemic syndrome.Methods: January 2014- November OIS patients in our hospital outpatient or inpatient admitted to a clinical diagnosis of ocular ischemic syndrome and carotid stenosis ≥70% in 20 cases, and both carotid stenting, according to eye direction of blood flow into the ophthalmic artery arterial blood flow in 12 patients and a positive ophthalmic artery flow reversal 8 patients, the application produced by Philip IU22 color Doppler, have the same operation performed by an experienced physician, probe frequency L12-5, sample volume before 1.0mm3 intraoperative and postoperative ophthalmic artery peak systolic velocity and central retinal artery, and best corrected visual acuity was observed.Patient supine, fully exposed to the neck, the choice of L9-3 probe on the machine within the carotid artery and carotid artery, external carotid artery cross-sectional and longitudinal continuity face detection. Color Doppler flow imaging in the two-dimensional image display, the sample volume to be detected in the blood vessels into the center, adjust the sampling frame and the direction of blood flow angle should be <60 degrees. Adjust the best sample volume, flow velocity draw a clear continuous spectrum, the spectrum is displayed continuously observed after 20 to 30 cycles, freeze the image, measuring the spectral Doppler flow parameters related to blood flow velocity parameters without changes.Patient supine, light eyes closed, the probe light is placed on the eyelids, explore ball after optic nerve sheath, the sheath of the optic nerve after the ball is the main indicator to determine the ophthalmic artery and central retinal artery, and after the ball at the optic nerve sheath 1.8 ~ 2.0cm next, you can explore the ophthalmic artery, the use of technology to observe CDFI direction ophthalmic artery(red for positive, blue for reverse) and adjust the sampling volume of 1.0mm3, measuring ophthalmic artery peak systolic velocity(peak systolic velocity, PSV, the unit cm / s). Central retinal artery located optic intrathecal, retrobulbar rear pole portion within about 5mm, adjust the optimum sampling volume size, the smallest angle, to observe the measurement utilizing CDFI central retinal artery PSV(unit cm / s). After the ball inside of the optic nerve sheath(nasal) technology use CDFI probe after nasal ciliary artery PSV(units of cm / s). Patients undergoing carotid stenting month, three months and six repeated measurements ophthalmic artery, central retinal artery and after nasal ciliary artery, observe and measure the blood flow direction PSV(unit cm / s).SPSS13.0 statistical software, select the appropriate statistical methods based on the data characteristics.The results of measurement data are mean ± standard deviation, the main indicators normality test,Ophthalmic artery group, central retinal artery group and post nasal ciliary artery groups: a "spherical symmetry" analysis, such as the normal distribution, and "spherical symmetry" is a direct repeat measurements analysis of variance can be corrected if not satisfied after the re-measurement data analysis of variance(lower-bound) F test, test P <0.01 was considered statistically significant. Between the various points of time for each group of paired T test, test P <0.0016(0.01 / 6).Results: 1 Best corrected visual acuity(BCVA): Forward group after one month, three months, six months compared with the preoperative best corrected visual acuity increased, the difference was statistically significant(P <0.05), the reverse group after 1 month, 3 months, 6 months compared with the preoperative best corrected visual acuity did not improve, the difference was not statistically significant(P> 0.05). 2 Stenosis rateForward narrow group before surgery was 81 ± 7.9%, OA average PSV was 24.4 ± 6.9cm / s, PCA average PSV was 9.6 ± 2.3cm / s, the results showed a significant negative correlation between the sample line, central retinal artery and carotid artery Wi-like relationship between stenosis; forward and reverse carotid stenosis surgery was 95.3 ± 4.7%, OA average PSV was 25.8 ± 4.9cm / s, PCA average PSV was 7.9 ± 0.3cm / s, the results showed a positive sample line correlation between radio-like relationship between the central retinal artery and carotid artery stenosis. 3 Artery group 3.1 Artery reverse after the first group of eight cases a month later, all restored to the forward direction of blood flow. 3.2 artery forward group, compare reverse PSV between groups, P = 0.000 <0.05, a statistically significant difference. 3.3 artery PSV forward group before and after surgery and ophthalmic artery reverse group, P = 0.000 <0.05, the difference was statistically significant, indicating that there is a difference between the forward and reverse group group. 3.4 artery before a different direction with the preoperative and postoperative groups a month, a comparison between the three-month and six-month, PSV increased, the difference was statistically significant. 4 central retinal artery group 4.1 Comparison of the central retinal artery PSV ophthalmic artery forward group and the reverse group, P = 0.000 <0.05, a statistically significant difference. 4.2 Group central retinal artery ophthalmic artery before and after the positive group compared with the reverse operation PSV, P = 0.847> 0.05, the difference was not statistically significant, indicating that the reverse ophthalmic artery for central retinal artery PSV meaningless. 4.3 Artery before a different direction with the preoperative and postoperative groups a month, a comparison between the three-month and six-month, PSV increased, the difference was statistically significant. 5 Nasal posterior ciliary artery group 5.1 Ciliary artery ophthalmic artery between the reverse of the forward group with PSV, P = 0.000 <0.05, the difference was statistically significant, indicating that there is a difference between the forward and reverse group group. 5.2 PSV artery ophthalmic artery before and after the forward group and the reverse group after surgery ciliary 3.2, P = 0.001 <0.05, a statistically significant difference. 5.3 Artery before a different direction with the preoperative and postoperative groups a month, a comparison between the three-month and six-month, PSV increased, the difference was statistically significant.Conclusion:1 CAS can significantly improve the rate of carotid artery stenosis.2 Posterior ciliary artery and carotid arteries before stenting, after a month, after three months and after six months of PSV by the directions of the ophthalmic artery.3 Before the central retinal artery internal carotid artery stenting, after a month, after three months and after six months of ophthalmic artery PSV unaffected direction.4 No matter how ophthalmic artery blood flow in the direction of the internal carotid artery stenting may improve the ophthalmic artery, central retinal artery and post nasal ciliary artery systolic peak velocity, and over time, the effect is more obvious.5 CAS postoperative visual acuity improved ophthalmic artery forward group, no significant improvement in visual acuity reverse. |
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